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Tummy tuck (abdominoplasty)

A tummy tuck (abdominoplasty) is an operation to remove excess fat and skin from your abdomen (tummy) and to tighten your abdominal muscles.

You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

Tummy tuck surgery removes excess fat and skin, and can tighten your abdominal muscles to improve the shape of your abdomen. It can also remove or reduce stretch marks, for example after pregnancy, and unwanted scars on your abdomen. Tummy tuck surgery isn’t a treatment to help you lose or control your weight and won’t stop you from gaining weight in the future either.

The results of a tummy tuck can be permanent as long as you maintain a healthy weight after your operation and exercise the muscles in your abdomen.

If you have a health condition such as heart disease or diabetes, if you’re very overweight or are a smoker then this kind of surgery may not be suitable for you. Talk to your surgeon for more information.

Details

It’s important not to rush into the decision to have this type of surgery. Talk to your GP about your options. He or she may be able to refer you to a reputable surgeon or advise you on how to choose a hospital to be treated in.

Before you decide whether to have a tummy tuck, talk to your surgeon about what you’re hoping to gain from the operation and the result you can realistically expect.

There are five main things to think about and do, which are listed below.

Think about what you want to change – find out all you can about the treatment/s you want.

Research potential surgeons, check they have the right qualifications and that they regularly do the type of procedure you want.

Have a thorough consultation – ask questions and make sure you understand the risks of surgery.

Take time to reflect before you make a final decision.

Think about your care after your operation, for example how you will be looked after, especially if there are any problems after your surgery.

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Your surgeon will explain how to prepare for your operation. For example, if you smoke you will be asked to stop, as smoking increases your risk of getting a chest and wound infection, which can slow your recovery. Smoking also reduces the amount of blood that reaches your skin, which means your wounds may heal more slowly.

Your surgeon may also advise you to:

lose excess weight – you should be as close to the ideal weight for your height as possible before your operation

stop taking the contraceptive pill four weeks before your operation, to reduce the chances of a blood clot (thrombosis) – make sure you use an alternative method of contraception

Tummy tuck surgery is done under general anaesthesia. This means you will be asleep during the operation.

You will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your surgeon and anaesthetist’s advice.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead. You will be asked to sign a consent form.

You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may need to have an injection of an anticlotting medicine called heparin as well as wearing compression stockings.

One of the main alternatives to tummy tuck is liposuction. This is where your surgeon uses a special machine to suck out excess fat from under your skin.

Liposuction may also be carried out during tummy tuck surgery or before or after as a separate procedure.

Having liposuction instead of a tummy tuck may be an option for you if your skin has good elasticity and you are mainly concerned about fat in a particular place on your body. Liposuction alone may not have as much effect as a tummy tuck and results may be unpredictable. There are also risks associated with liposuction to consider. Your surgeon will discuss any alternative options with you.

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Depending on how much fat and skin you’re having removed and the technique your surgeon is using, the operation may take around three hours.

There are several types of tummy tuck. The one you have will depend on how much skin and fat you have removed. Your surgeon will explain which type is most suitable for you. Liposuction may done at the same time as your surgery but your surgeon will advise if this is suitable for you.

Standard tummy tuck

Your surgeon will make a cut in your abdomen from hip to hip along your pubic area (in women this is also called your) bikini line. He or she will make another cut around your belly button to free it from the surrounding skin. Your surgeon will repair and tighten your abdominal muscles and will remove the excess fat and skin. The remaining skin is then pulled down and a new hole is made for your belly button to appear through in the correct position.

You will have a scar around your belly button and a long curved scar on your abdomen above your pubic area. You can usually hide these scars with your underwear or with swimwear such as a bikini, but this may not always be possible.

Mini tummy tuck

You can have a mini tummy tuck if you need a small amount of skin or fat removing. Your surgeon will remove excess skin and fat from below your belly button, leaving a long curved scar on your abdomen above your pubic area. Your belly button stays in the same place.

Extended tummy tuck

If you have a lot of excess skin, after losing a large amount of weight for example, you may have an extended tummy tuck. This is also known as a lower body lift. With this procedure the excess skin and fat from your abdomen and lower back is removed. You will have a scar around your belly button and a long curved scar on your abdomen above your pubic area, and around your lower back.

The picture below shows an example of the position of the scars that you may have after a tummy tuck. This will differ from person to person and depending on the type of tummy tuck you have. Your surgeon will explain the scars you’re likely to have.

How long you need to spend in hospital will depend of which procedure you have done. You may need to stay in hospital for two to four days after your surgery. You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off. Tummy tuck may be quite painful, so you will be offered painkilling injections, an infusion or tablets if you need them.

You will have some dressings and may also have fine tubes coming out of the wound. The tubes drain any blood and fluid into a bag and are usually removed before you go home. You may have a drip in your arm to keep you hydrated and for medication. It’s usually removed when you can drink enough fluid.

You will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours after your tummy tuck.

General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, contact your motor insurer so that you're aware of their recommendations, and always follow your surgeon’s advice.

You may be advised to keep your knees bent when you’re in bed, or to bend at the waist, to prevent putting strain on your stitches.

You may have dissolvable stitches or stitches that need to be removed. The length of time your dissolvable stitches will take to disappear depends on what type you have. Your surgeon will tell you how long this may be and whether you have any stitches that may need to be removed. He or she will also give you advice about your dressings.

It usually takes about six weeks to make a full recovery from a tummy tuck, but this varies between individuals and the technique used, so it's important to follow your surgeon's advice. Usually you can return to work four weeks after your operation.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

You may be advised to wear a support garment (a type of corset) for up to six weeks after your surgery. This helps to ease pain and discomfort and reduce any swelling.

You will usually be able to do light activities comfortably about 10 to 20 days after your surgery. Don’t do any vigorous activity for at least six weeks. Your surgeon will give you specific instructions depending on the type of operation you have.

As with every procedure, there are some risks associated with tummy tuck surgery. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure.

Side-effects of a tummy tuck may include:

pain

bruising

swelling

scarring – these usually fade over time, but won't completely disappear

Complications

Complications are when problems occur during or after the operation.
The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).

Complications of a tummy tuck may include:

infection – this may need antibiotic treatment

bleeding under your skin (haematoma) – this may need surgery to stop the bleeding and drain the area

seroma – a collection of fluid around your wound that may need to be removed using a needle

numbness – this can be permanent

unusually red or raised scars – these may take several months to fade

a blood clot in the lungs (pulmonary embolus)

wound-healing problems – these can slow down your recovery and cause more noticeable scars

After having twins, my stomach isn't toning up even though I exercise regularly. Will a tummy tuck help flatten my stomach?

Answer

Yes, a tummy tuck (abdominoplasty) can help tighten stretched skin and muscles in your lower abdomen (tummy) that may have been caused by pregnancy.

Explanation

When you’re pregnant your abdomen stretches as your baby grows and this stretches the skin and the muscles. When your baby is born the skin on your abdomen can become less elastic and baggy, particularly if you also lose weight after your pregnancy. If you have more than one baby, loose excess skin is more likely to develop. When you’re pregnant the muscles of the abdomen can also separate in the middle. This is called diastasis.

Tummy tuck surgery can remove any excess skin from your tummy and tighten and repair your abdominal muscles. However, ideally you shouldn’t have a tummy tuck if you plan to have another baby because this will stretch your skin again.

How do I know whether a tummy tuck is right for me?

Answer

It’s important to make an informed decision about any type of surgery – gather information about the operation, including the risks and benefits, as well as information about different hospitals, clinics and surgeons. Only you can decide whether the operation is right for you.

Explanation

Don’t rush into a decision to have cosmetic surgery. Discuss your options with your GP who may know of any specialists in your area and can pass on any important health information from your medical records.

Before opting for a tummy tuck, discuss with your surgeon what you’re hoping to gain from the operation and the results you can realistically expect. There are risks as well as benefits associated with any cosmetic surgery. You need to consider your options and the risks of surgery carefully when making your decision.

The surgeons that carry out cosmetic surgery are usually plastic surgeons. Some plastic surgeons carry out aesthetic surgery (to improve appearance), whereas others specialise in areas such as reconstruction or burns.

Plastic surgery is one of the nine main specialties recognised by The Royal College of Surgeons. Consultant plastic surgeons are listed as being fully trained on the GMC Specialist Register. This means that they have completed specialist training in plastic surgery (usually for six years).

All surgeons who set up as cosmetic surgeons for the first time from April 2002 must also be on the GMC's Specialist Register. You can check the specialist register by looking at the General Medical Council’s website (see Resources).

Before deciding to go ahead with cosmetic surgery, you should meet with your surgeon. Don’t be afraid to ask him or her about their qualifications and experience. Ask whether he or she belongs to a professional association, such as the British Association of Plastic Reconstructive and Aesthetic Surgeons or the British Association of Aesthetic Plastic Surgeons. Both of these organisations can help you to find a surgeon.

How long will it be before I see the final results of my tummy tuck?

Answer

It may be several weeks before you see the final result of your tummy tuck.

Explanation

You will notice some swelling to begin with. This usually disappears after several weeks.

You will also have scars. These are usually red or pink in colour and raised initially. Your scars tend to fade but most scars will be permanently visible. Some people may find their scars are very faint whereas others may find their scars to be more noticeable.

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